Individual
JAQUALA TEALER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
939 N MAIN ST, WICHITA, KS 67203-3608
(316) 712-6874
Mailing address
2812 E 2ND ST N, WICHITA, KS 67214-4704
(316) 587-7472
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
23-54948-041
KS
Other
Enumeration date
07/22/2025
Last updated
07/22/2025
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